Age related compositional plaque burden by CT in patients with future ACS.
J Cardiovasc Comput Tomogr
BACKGROUND: We examined age differences in whole-heart volumes of non-calcified and calcified atherosclerosis by coronary computed tomography angiography (CCTA) of patients with future ACS.
METHODS: A total of 234 patients with core-lab adjudicated ACS after baseline CCTA were enrolled. Atherosclerotic plaque was quantified and characterized from the main epicardial vessels and side branches on a 0.5 mm cross-sectional basis. Calcified plaque and non-calcified plaque were defined by above or below 350 Hounsfield units. Patients were categorized according to their age by deciles. Also, coronary artery calcium scores (CACS) were evaluated when available.
RESULTS: Patients were on average 62.2 ± 11.5 years old. On the pre-ACS CCTA, patients showed diffuse, multi-site, predominantly non-obstructive atherosclerosis across all age categories, with plaque being detected in 93.5% of all ACS cases. The proportion calcified plaque from the total plaque burden increased significantly with older presentation (10% calcification in those <50 >years, and 50% calcification in those >80 years old). Patients with ACSpatients, but a high proportion of high risk markers such as low-attenuation plaque. CACS was >0 in 85% of the patients older than 50 years, and in 57% of patients younger than 50 years.
CONCLUSION: The proportion of calcified plaque varied depending on patient age at the time of ACS. Only a small proportion of plaque was calcified when ACS occurred atold, while this increased gradually with older age. Purely non-calcified atherosclerotic plaque was not uncommon in patients <50 >years.
van Rosendael AR, van den Hoogen IJ, Lin FY, Gianni U, Lu Y, Andreini D, et al [Chinnaiyan K]. Age related compositional plaque burden by CT in patients with future ACS. J Cardiovasc Comput Tomogr. 2022 May 31:S1934-5925(22)00073-9. doi: 10.1016/j.jcct.2022.05.005. Epub ahead of print. PMID: 35725722.